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Published in:

01-03-2018

Near-infrared cholecystocholangiography with direct intragallbladder indocyanine green injection: preliminary clinical results

Authors: Yu-Yin Liu, Chien-Hung Liao, Michele Diana, Shang-Yu Wang, Seong-Ho Kong, Chun-Nan Yeh, Bernard Dallemagne, Jacques Marescaux, Ta-Sen Yeh

Published in: Surgical Endoscopy | Issue 3/2018

Abstract

Background

Near-infrared (NIR) fluorescence cholangiography by systemic administration of indocyanine green (ICG) enhances the visualization of the biliary tree anatomy. However, the simultaneous enhancement of liver parenchyma can disturb the visualization of critical details. We herein proposed a new technique of NIR cholecystocholangiography by intragallbladder ICG injection to increase the safety during laparoscopic cholecystectomy.

Methods

A total of 46 patients scheduled for laparoscopic cholecystectomy for symptomatic lithiasis (n = 21) or cholecystitis (n = 25) were enrolled. A fluorescence cholangiography by direct gallbladder injection of ICG was performed in all cases. Of them, the ICG was injected through a previously placed percutaneous transhepatic gallbladder drainage catheter (n = 18) or by intraoperative, percutaneous needle puncture of the gallbladder (n = 28). Visualization of biliary structures, including the cystic duct (CD), the common bile and hepatic ducts (CBD and CHD), the gallbladder neck, and the Hartmann’s pouch (HP), was performed using White Light (served as control modality) and by NIR enhancement.

Results

Cholecystocholangiography provided a significantly higher rate of visualization of the CD in case of cholecystitis with mild adhesions, and an improved visualization of the HP, CBD, and CHD in case of severe inflammation, when compared to White Light observation. There were no benefits of NIR in case of non-inflamed lithiasis.

Conclusions

Clinical translation of NIR cholecystocholangiography has been successful with a noise-free visualization of biliary anatomy. It can be considered in difficult cases to increase the safety of laparoscopic cholecystectomy.

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Title: Near-infrared cholecystocholangiography with direct intragallbladder indocyanine green injection: preliminary clinical results
Authors: Yu-Yin Liu
Chien-Hung Liao
Michele Diana
Shang-Yu Wang
Seong-Ho Kong
Chun-Nan Yeh
Bernard Dallemagne
Jacques Marescaux
Ta-Sen Yeh
Publication date: 01-03-2018
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 3/2018
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-017-5838-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Near-infrared cholecystocholangiography with direct intragallbladder indocyanine green injection: preliminary clinical results

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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